Contributions
Abstract: P369
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Background: Reduction of brain volume occurs in clinically active disease and correlates with progressive disability in multiple Sclerosis (MS). Although dysarthria is highly prevalent in MS, it only becomes clinically relevant in advanced stages of the disease. The relationship between early sub-clinical markers of dysarthria and overall disease severity is poorly understood.
Aim: To examine the relationship between an objective marker of speech performance and validated clinical scores for disease severity in non-dysarthric subjects with relapsing-remitting and secondary progressive MS.
Method: An experienced neurologist scored patients according to the Expanded Disability Status Scale (EDSS) and the Scale for the Assessment and Rating of Ataxia (SARA). Acoustic analysis was used to investigate the diadochokinetic speed in “as fast as possible” repetition of the meaningless word /pa/ta/ka/. Brain images were acquired using 3 Tesla magnetic resonance. Images were automatically segmented using FreeSurfer (5.7) to determine volumes for whole brain (excluding ventricules) and cerebellum. Lesions were automatically segmented by the lesion prediction algorithm as implemented in the Lesion Segmentation Tool version 2.0.15 for SPM (Statistical Parametric Mapping software). Statistical correlations were processed in SPSS (v 23.0) controlling for age. After adjustment for multiple comparisons, a p< 0.01 was considered for statistical significance.
Results: We assessed 35 MS patients with normal speech (i.e. SARA speech sub-score 0-1; age=47.7±12years; disease duration=13.2±8.4). Diadochokinetic rate (mean=5.63±0.83 syllables per second) directly correlated with EDSS (Spearman's rho=0.454, 2-tailed p=0.007; median EDSS=3.5, interquartile range=3.5) and SARA (rho=0.515, p=0.002; SARA median=9, interquartile range 11.975), but not with whole brain volume (p=0.022), lesion load (p=0.032) or cerebellar volume (p=0.037).
Conclusion: Changes in acoustic markers can be detected before overt dysarthria in MS and reflect overall disease severity. Larger and longitudinal studies are needed to understand if those markers can help monitoring disease progression.
Disclosure:
- Gustavo Noffs has nothing to declare
- Frederique Boonstra has nothing to declare
- Thushara Perera has nothing to declare
- Camille Shanahan has nothing to declare
- Adam Vogel has received consulting fees from Cogstate and Takeda.
- Andrew Evans has received honoraria from Novartis for giving presentations and providing consultancy services. He has participated in scientific advisory board meetings for Novartis, UCB Pharma, Allergan, and Boehringer Ingelheim. He has received conference travel support from Boehringer Ingelheim.
- Helmut Butzkeuven has received consulting fees from Genzyme, Biogen, Novartis, Merck and Oxford PharmaGenesis and grant/research support from Biogen, Novartis, Merck and Genzyme
- Anneke van der Walt has received travel support from Biogen Idec, Novartis, Teva, Merck and serves on several advisory boards
- Scott Kolbe receives grant income from the National Health and Medical Research Council of Australia and has received honoraria from Novartis
Abstract: P369
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Background: Reduction of brain volume occurs in clinically active disease and correlates with progressive disability in multiple Sclerosis (MS). Although dysarthria is highly prevalent in MS, it only becomes clinically relevant in advanced stages of the disease. The relationship between early sub-clinical markers of dysarthria and overall disease severity is poorly understood.
Aim: To examine the relationship between an objective marker of speech performance and validated clinical scores for disease severity in non-dysarthric subjects with relapsing-remitting and secondary progressive MS.
Method: An experienced neurologist scored patients according to the Expanded Disability Status Scale (EDSS) and the Scale for the Assessment and Rating of Ataxia (SARA). Acoustic analysis was used to investigate the diadochokinetic speed in “as fast as possible” repetition of the meaningless word /pa/ta/ka/. Brain images were acquired using 3 Tesla magnetic resonance. Images were automatically segmented using FreeSurfer (5.7) to determine volumes for whole brain (excluding ventricules) and cerebellum. Lesions were automatically segmented by the lesion prediction algorithm as implemented in the Lesion Segmentation Tool version 2.0.15 for SPM (Statistical Parametric Mapping software). Statistical correlations were processed in SPSS (v 23.0) controlling for age. After adjustment for multiple comparisons, a p< 0.01 was considered for statistical significance.
Results: We assessed 35 MS patients with normal speech (i.e. SARA speech sub-score 0-1; age=47.7±12years; disease duration=13.2±8.4). Diadochokinetic rate (mean=5.63±0.83 syllables per second) directly correlated with EDSS (Spearman's rho=0.454, 2-tailed p=0.007; median EDSS=3.5, interquartile range=3.5) and SARA (rho=0.515, p=0.002; SARA median=9, interquartile range 11.975), but not with whole brain volume (p=0.022), lesion load (p=0.032) or cerebellar volume (p=0.037).
Conclusion: Changes in acoustic markers can be detected before overt dysarthria in MS and reflect overall disease severity. Larger and longitudinal studies are needed to understand if those markers can help monitoring disease progression.
Disclosure:
- Gustavo Noffs has nothing to declare
- Frederique Boonstra has nothing to declare
- Thushara Perera has nothing to declare
- Camille Shanahan has nothing to declare
- Adam Vogel has received consulting fees from Cogstate and Takeda.
- Andrew Evans has received honoraria from Novartis for giving presentations and providing consultancy services. He has participated in scientific advisory board meetings for Novartis, UCB Pharma, Allergan, and Boehringer Ingelheim. He has received conference travel support from Boehringer Ingelheim.
- Helmut Butzkeuven has received consulting fees from Genzyme, Biogen, Novartis, Merck and Oxford PharmaGenesis and grant/research support from Biogen, Novartis, Merck and Genzyme
- Anneke van der Walt has received travel support from Biogen Idec, Novartis, Teva, Merck and serves on several advisory boards
- Scott Kolbe receives grant income from the National Health and Medical Research Council of Australia and has received honoraria from Novartis